PATIENT: Bryan Moore
DATE: October 6, 2005

• Take 100 mg of 5-HTP one hour before bed each night. If there is no improvement in 4-5 days, increase to 150 mg, and if no improvement in another 4-5 days increase the dosage to 300 mg. Do not take more than 300 mg nightly without the approval and supervision of a physician.
• Take 0.5 mg of melatonin each night, directly before bed and just as you are turning the lights out. Do not take a sublingual form as the half life of melatonin is less than 40 minutes and you will not get the desired effect. Take 0.5 mg nightly for 30 days. If there is no improvement, increase the dosage to 3 mg, and each week by an additional 3 mg. Do not increase the dosage beyond 9 mg nightly.
• Enhance natural melatonin secretion. Make sure your room is dark and that little extraneous light enters, such as from streetlights.
• Avoid nighttime hypoglycemia. Eat protein foods in the morning and at noon, and carbohydrates in the evening. Eat a light carbohydrate snack about 30 minutes before bed (1/2 cup of cereal with milk or rice or soymilk, yogurt, whole wheat toast, 1/2 cup warm milk or chamomile tea with honey).
• Herbal Additions: Try the above regimen for about two weeks, if there is still no improvement continue the same protocol and add one of the following two hours before bed nightly for a trial of about 10 days:
  • Kava kava (30% Kava lactones) - 200-600 mg
  • Valerian Extract (0.2-0.8% or higher concentration of valerenic acid) - 150-500 mg
• GABA may help sleep patterns. Take 50-150 mg 2-4 hours before sleep.
• Inositol can also help improve sleep. Take 500 mg 2 hours before sleep.

If the suggestions in this protocol do not help improve your sleep, call to set up an appointment. In stubborn cases of insomnia and sleep disturbances, hormones can be out of balance or deficient, or neurotransmitters disrupted. Resetting brain function and balancing hormones is a complicated clinical task requiring a skilled physician. If you should have any questions, please call me at (941) 929-1901.